My first year after completing surgical residency was exhilarating and exhausting; an experience most physicians will recall as part of their training. The American medical culture has imagined that the nation's doctors - no matter their workload - simply don't reach physical or emotional exhaustion in their work. But they do, and as we debate the future of healthcare in our country, we need to address this problem and quickly get to solutions, helping ensure that the practitioners closest to tomorrow's patients can always be at their absolute best.

To define the problem, look at the three fundamental factors common to any American doctor's routine...

Hate your job? You may be in the right profession, but the wrong position for your personality. Want to love your life and career? Step one: discover whether you are an employee, a business owner or an entrepreneur.

This is a great article for physicians and non-physicians. Dr. Wible explains succinctly how to figure out which profile best fits your personality.

In an 8.6.17 post, MD Whistleblower ponders the ethical dilemma created by the recent announcement that gene editing has been applied to fix diseased genes in viable human embryos:

<We have> learned of an astonishing scientific breakthrough that seems utterly fantastic and futuristic, even though it has actually occurred. Scientists amended the DNA of human embryos to correct a mutation - a genetic defect - that causes a very serious medical disease. This suggests that with additional research and testing that embryos who otherwise might be destined for misery could be rescued...The fact that there is a fortune to be made in the genetics industry can be expected to alter the direction of our ethical compass. And, while the initial roll-out will be discussing how genetic intervention can reverse the course of devastating and fatal diseases, does anyone believe it will stop there? Once the concept has been normalized, other medical conditions will be targeted. The creep will be inexorable. Boundaries will be shattered.

The need for what we are calling medical "quality" is acute, yet the strategies employed to obtain it are destroying medicine. Patient outcomes are inconsistent, care varies depending on many factors outside of disease state, and the cost of our medical system is not sustainable. But to fix this, most health systems employ non-clinicians to audit charts while checking boxes such as "A1C<8%?" and "DVT prophylaxis ordered within 24 hours?" These non-providers then send threatening letters and cut salaries with "pay-for-performance." Unsurprisingly, such efforts are not working, and only end up creating distorted physician-patient relationships. Yet, obtaining improved quality requires only a few key steps...

Diabetes, hypertension and obesity are the chronic illnesses that grab headlines and the attention of health care policymakers. Yet chronic kidney disease, most commonly the result of one or a combination of these three conditions, flies under the radar.

That's despite 26 million Americans having chronic kidney disease, nearly comparable to the number who have diabetes. The condition is the ninth-leading cause of death in the U.S.

"Kidney disease is very much underrecognized in the general population," says Gerald Hladik, MD, chief of the University of North Carolina Division of Nephrology and Hypertension. "Everybody knows about cancer and heart disease, but not many people think about kidney disease. But it's just as important, with a prevalence that's often higher than many forms of cancer, and outcomes that are quite severe."

President Trump on Friday signed Veterans Affairs reform legislation meant to protect whistleblowers while making it easier to fire problematic employees at the department... The Department of Veterans Affairs Accountability and Whistleblower Protection Act passed by Congress earlier this month streamlines the process to remove, demote, or suspend VA employees for poor performance or misconduct. In addition, it authorizes the VA secretary to recoup any bonuses awarded to employees who have acted improperly.

The bill enjoyed broad bi-partisan support and fulfilled a Trump campaign promise. The ongoing VA debacle is a cautionary tale for proponents of a single payer system.

When it comes to adding any new service, especially telehealth, the first question many of you have relates to reimbursement. If you read last week's article you discovered the need, some of the benefits and how easily telehealth is to implement. Today we're going to discuss reimbursement, key drivers and what you should look for in telehealth technology.

As far as telehealth is concerned, Medicare Part B covers certain services, like office visits and consultations that are provided with these two stipulations...